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The Role of Nutrition in Infants Approximately 40-55% of Total Energy in Breast Breastfeeding Reduces the Incidences of Milk Is Comprised of Lipids

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The Role of Nutrition in Infants Approximately 40-55% of Total Energy in Breast Breastfeeding Reduces the Incidences of Milk Is Comprised of Lipids Clinical baby will only require around one teaspoon of the birth. A poor diet can reduce the nutrient colostrum per feed due to its high concentration.9 stores for the mother, as any form of nourishment After 2-3 days postpartum, breast milk is prioritised for the baby.15 Module 1971 increases significantly in volume, with the start In England, around 80% of women will of any feed containing much more fluid and the breastfeed in the first instance, as stated by the end changing to become much more energy and Royal College of Paediatrics and Child Heath.16 The role of nutrition in nutrient rich.10 Colostrum promotes the expulsion However, only 45% exclusively breastfeed of meconium; the black, tar-like faeces produced one week after birth and only 21% at six infants after the baby is born.11 weeks.6 Approximately 10% of newborns are not breastfed within the first hour of life, as From this CPD module you will learn: Breast milk composition recommended by WHO.17 • The role of nutrition in infants Approximately 40-55% of total energy in breast Breastfeeding reduces the incidences of milk is comprised of lipids. Lipids are presented in common childhood illnesses including ear, chest • Benefits and rates of breastfeeding breast milk as milk fat lipid globules, which form and gut infections, as well as the development of • Infant formula as an alternative to breastfeeding the structure of the milk. As well as providing atopic conditions such as eczema, asthma and hay over 200 fatty acids to the infant, lipids have fever. Treating these conditions in infants costs • The role of the pharmacy team also shown to aid in the full development of the National Health Service (NHS) approximately the gastrointestinal tract.5 The lipids are also £50 million each year.14 necessary for brain, nervous system and retinal Some mothers are unable to or have difficulty maturation.12 The high content of lipids ensures breastfeeding. For example, if a mother is on MALA MAHASURIA, PHARMACIST infant nutrition tends to begin with breast milk, that the infant is sated but also ensures that certain medications, undergoing chemotherapy especially during the first six months of life. energy is supplied for adequate growth.10 or taking antiretroviral therapy for HIV infection, The pharmacy is an ideal environment for parents Following on from this, a combination of breast Breast milk also contains antibodies. breastfeeding is contraindicated, as these to obtain reliable and evidence-based information milk and solids should be initiated between six Colostrum in particular has an abundant supply when it comes to caring for their baby. Infant months and two years of age, as recommended of antibodies, particularly immunoglobulin nutrition is not just about breastfeeding by the World Health Organisation (WHO).3,4 A, which plays a key role in the mucus nowadays. With a vast range of infant formula membranes.13 Proteins, vitamins and non- milk available and with current advice stating The role of breast milk protein nitrogen also play key roles in that a parent should always speak to a healthcare Breast milk is a biological fluid comprised of a providing essential nutrition, mucosal professional in the first instance, it is imperative tailored set of nutrients, energy, immunity and repair and immunity.10 that all pharmacy team members are kept up to growth factors provided to the baby throughout date with the latest information. infancy.5 The components of breast milk adapt Benefits and risks of to the needs of the infant as it grows. Breast milk breastfeeding Why is nutrition important? can protect infants from disease by providing For the mother, breastfeeding Adequate nourishment is vital for development immunisation. It can also inhibit inflammation, can reduce the risk of diabetes and wellbeing.1 Nutrition is important for creating advance antibody production and can provide by 30% and hypertension by strong a immune system, supporting brain the immune system with the ability to recognise 13%.14 It can stimulate uterine development and increasing both length and microorganisms in the respiratory tract and gut.6 contraction, meaning better quality of life. Good nutrition can lower the risk post-partum weight loss and of modifiable diseases such as obesity, type 2 Colostrum increased uterine tone. If a diabetes and high cholesterol along with other Breast milk constantly adapts to the needs of the mother is solely breastfeeding, cardiovascular complications.2 infant. Colostrum is described as breast milk that she could burn as many as 500 The requirements of macro/micronutrients, is produced during the first few days of life. It has calories per day.1,11 It is imperative vitamins, minerals and water varies at each stage a large concentration of antibodies compared to that the mother eats well during of development and it is widely recognised that regular breast milk and is much less diluted.7,8 The pregnancy as well as following chemistanddruggist.co.uk/update-plus March 2021 | Module 1971 | The role of nutrition in infants | 1 of 5 medications are all present in the breast milk. difficult to make an informed decision. There are Other reasons to not breatfeed include not two different types; dry powder, which requires producing enough milk, returning to work and the addition of water, or ready-to-feed bottles.20 being unable to express milk or for religious It is important to also know that the formula reasons. The baby may be unable to latch on to milk industry has to comply with European law, the breast properly or the breasts can become which sets out the nutritional composition for engorged and painful making breastfeeding manufactures to adhere to. The composition difficult.18 For whatever reason a mother is must comprise of protein, fats, carbohydrates, unable to feed, there are plenty of infant formula vitamins and minerals. However, producers options on the market, as pure cows’ milk is can develop their own combinations within not recommended for babies under 12 months these guidelines.21,22 of age.19 First infant formula Infant formula milk First infant formula (first milk) unless stated The Department of Health states that infant otherwise by a midwife, health visitor or GP, is the formula can be used alone for the first six only milk the baby needs for the first six months months. Infant formula milks should only be used and up to one year. After this, the infant can be Equipment for bottle feeding should be washed in cold water prior to sterilisation if recommended by an appropriate healthcare switched to pasteurised cows’, goats’ or sheep’s professional. milk.23,24 First infant formula based on whey Other milks Cleaning and sterilising It is impossible to replicate breast milk and with protein is thought to be easier to digest than other • Lactose free – although lactose intolerance It is important to sterilise all equipment used a wide range of brands on the market, it can be types of formula.24 is rare in babies, it can cause abdominal pain, when bottle feeding. This is to prevent the Goats’ milk formula is also an option but is not bloating and diarrhoea.19 development of infections, vomiting and recommended as an alternative if the infant has a • Hungrier baby – while there is no evidence to diarrhoea. Bottles, teats and other equipment cows’ milk allergy due to the similarity in proteins suggest that infants are sated after using this must be washed in hot, soapy water as soon as shared by both types of milk. formula, hungry milk contains more casein than possible after feeds. Specific brushes for the whey, which takes longer to digest.19 bottle and teat are preferred but a dishwasher Comfort and hypoallergenic milk • Follow-on – fed from six months and older can be used, although it should be emphasised Comfort milk is when the proteins in the milk are only, research shows that there is no benefit to that they are not sterile at this point with either partially hydrolysed meaning that the proteins switching to this milk at six months.19 method.25 in cows’ milk is broken down slightly to make the • Good night – with added cereal, this is The equipment must be then washed in cold amino acid chains smaller. The shorter the protein designed to be given at bedtime. There is no water prior to sterilising. There are three options chains, the easier it is for the milk to be digested evidence to suggest that infants sleep better for sterilising; cold water, steam or boiling.25 and therefore there may be a reduction in after being fed this milk.19 Cold water sterilising: An example is Milton digestive problems such as colic and constipation. • Growing up – there is no evidence to suggest sterilising fluid, which is commonly sold in Hypoallergenic milk is fully hydrolysed and is this provides better nutrition than regular milk pharmacies. The equipment is steeped in this fluid indicated for infants with cows’ milk allergies. for toddlers aged one year and above. for 30 minutes. There should be no air bubbles • Soya – this is only suitable from six months present so that every section is fully sterile. Milton Anti-reflux formula old and only under medical supervision. sterilising fluid should be changed every 24 hours. This formula is thickened to reduce the incidences This is occasionally used in those who have Steam: Steaming involves the purchasing of a of severe reflux in infants. Anti-reflux formulas a cows’ milk allergy. However, due to the device and following manufacturer instructions are usually reconstituted at lower temperatures content of phytoestrogens there are some on how to steam. The equipment should be left than normal formulations because they can concerns that consumption can affect the in this device until they are next required but become lumpy.
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